Deficiencies in Detecting Autism Spectrum Disorder in Females


The diagnosis of Autism Spectrum Disorder (ASD) has a significant gender difference. According to “Linguistic camouflage” could complicate the diagnosis of Autism Spectrum Disorder in girls”, girls are about four times less likely than boys to be diagnosed with ASD.  A possible explanation for these large gender discrepancies could be due to differences in diagnostic techniques–not the lack of prevalence of the disorders in females.  According to  Gender and Autism, “Various studies, together with anecdotal evidence have come up with men/women ratios ranging from 2:1 to 16:1”.  Often times, girls can be diagnosed later in life or not at all. This results in less early intervention which is crucial for the development of those on the spectrum.  According to the Autism Spectrum Disorder Foundation, “Children who receive autism-appropriate education and support at key developmental stages are more likely to gain essential social skills and react better in society”. This results in an overwhelming amount of women and girls who are not receiving the support  they need.  

Experts in the field have noted obvious differences among males and females on the spectrum. An article in National Public Radio (NPR), ‘Social Camouflage’ May Lead To Underdiagnosis Of Autism In Girls identifies that, “Boys more likely to exhibit repetitive behaviors, fixated interests and being less likely to engage in social interactions. Girls tend to be more verbal and socially interactive, at least at younger ages.” This difference is certainly a contributor to the current diagnostic methods present in ASD. A recent study looked deeper into the cause of this trend and found that females with ASD are more likely to display behavior that has been termed “social camouflaging”.  

Social camouflage is characterized by modifying typical behaviors to blend in with peers (Morris, Schultz 2017). An example of “camouflaging” is well explained by The British Psychological Society, “if an autistic person maintains eye contact during a conversation because they have learnt that this is socially appropriate, even though this clashes with how they really want to behave, this would be an example of camouflaging”.

Behaviors such as these contribute to diagnosticians lack of recognition of the disorder in females, since they are more geared towards male ASD tendencies.  The development of innovative techniques could lead equal diagnostic capabilities and early intervention to give them the same opportunities for wellness as those who do not display camouflaging behavior.

Gender and Autism points out that men tend to excel more in the general population at visuo-spatial activities, while females tend to excel in verbal skills.  They then conclude that due to this general tendency and the false perception of the male ASD stereotype, males are quicker to be diagnosed with ASD than females.  Therefore, “no direct analogy can be drawn between the poorer verbal skills of boys and the higher incidence of autism in men and boys”.  

Neuroimaging has been suggested by studies to aid in the diagnosis of ASD by detecting brain abnormalities which are typically present. These techniques are not designed to replace traditional behavioral assessment of ASD, but are beneficial in supplementing them.     According to “Neuroimaging-based methods for autism identification: a possible translational application?”, “Traditional neuroimaging analysis approaches were designed mainly to reveal brain abnormalities by statistically comparing data from two groups of subjects (usually affected subjects and a control group) either matched or controlled for possible confounding variables ”.  Though as of yet, the techniques have not made any move to a clinical setting due to its lack of recognition by American Academy of Neurology and Child Neurology Society as an effective diagnostic tool, but researchers are continuing to study neuroimaging in order to assert their arguments .  In the future, neuroimaging may prove to assist clinician in the diagnosis of ASD, and reduce diagnostic gender disparities by reducing subjectivity present in behavioral assessments which are under the influence of perceived stereotypes.

The expression of ASD in females needs to be better understood through more extensive research in order to prevent neglect. It is up to the psychological community to provide revisions in diagnostic techniques in order to identify females with ASD at an earlier age, so they do not continue to go through life without a diagnosis

 

 

Citations:

“Autism and gender.” The National Autistic Society,

www.autism.org.uk/about/what-is/gender.aspx.

 

“Early Intervention Makes a Huge Difference for Children with Autism.” Autism Spectrum

Disorder Foundation, myasdf.org/site/media-center/articles/early-intervention-makes-a-huge-difference-for-autistic-children/.

 

“Free stock photo of black-and-White, blood pressure, blood pressure monitor.” Free Stock

Photos,www.pexels.com/photo/black-and-white-blood-pressure-blood-pressure-monitor-close-up-208556/.

 

Hasselmann, Helge . “There’s such a thing as.” Research Digest, 3 Apr. 2017,

https://digest.bps.org.uk/2017/02/24/theres-such-a-thing-as-autism-camouflaging-and-it-might-explain-why-some-people-are-diagnosed-so-late/

 

Julia Parish-Morris & Robert T. Schultz 2 Oct 2017. “”Linguistic camouflage” could complicate

the diagnosis of Autism Spectrum Disorder in girls.” On Health, 2 Oct. 2017,

blogs.biomedcentral.com/on-health/2017/10/02/linguistic-camo.

 

Neighmond, Patti, and Jane Greenhalgh. “’Social Camouflage’ May Lead To Underdiagnosis Of

Autism In Girls.” NPR, NPR, 31 July 2017,

www.npr.org/sections/health-shots/2017/07/31/539123377/social-camouflage-may-lead-to-underdiagnosis-of-autism-in-girls.

 

Retico, Alessandra, et al. “Neuroimaging-Based methods for autism identification: a possible

translational application?” Functional Neurology, CIC Edizioni Internationali, 2014,

www.ncbi.nlm.nih.gov/pmc/articles/PMC4370436/.

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